Treatment for Diabetic Nephropathy

Treatment principles for Diabetic Nephropathy goes as follow:(1) strict control of blood glucose, blood glucose near normal levels as possible to prevent and delay the occurrence of diabetic nephropathy; ② slow the rate of kidney dysfunction; ③ dialysis treatment and kidney transplantation.
1. Strict control of blood glucose, before the onset of clinical diabetic nephropathy is in the early stage of diabetes, insulin pump or multiple subcutaneous insulin strict control of diabetes, blood sugar basically normal, can delay or even prevent the occurrence and development of diabetic nephropathy and reduce increased glomerular filtration rate and improve microalbuminuria. Are other complications benefits. According to DCCT study, T1DM intensive treatment with insulin, 35% -55% reduction in the risk of diabetic nephropathy. Has been developed to clinical diabetic nephropathy, proteinuria, little help control blood sugar their disease progresses. Generally should be used instead of insulin antidiabetic drugs in clinical diabetic nephropathy.
Control of hypertension, high blood pressure will promote the development of renal failure, effective antihypertensive therapy can slow the rate of decline in glomerular filtration rate, reduced urinary albumin excretion. Angiotensin-converting enzyme inhibitors or angiotensin II receptor antagonists can be used as the drug of choice, often in combination with other antihypertensive drugs. Other antihypertensive drugs such as calcium antagonists, diuretics, beta-blockers, methyldopa, clonidine, etc. is also effective. Diabetes, blood pressure ≥ 130 / / 80mmHg should with antihypertensive drugs, should be controlled below 130 / / 80mmHg. Treatment with antihypertensive drugs, the relative health of the glomerular glomerular capillary pressure drop and continue to survive, while the already damaged glomerular soon completely blocked, the water can not be filtered, the protein can not escape. Was observed in 135 / / 85-mmHg blood pressure dropped from 160 / / 95mmHg, urinary protein excretion was significantly reduced, the rate of decline in glomerular filtration rate dropped from lml / / min · January 0.35ml / / min · month . Survival of patients with diabetic nephropathy was significantly prolonged antihypertensive treatment before the 10-year cumulative mortality of 50% -70% to 18% after treatment. Antihypertensive treatment of diabetic retinopathy.
3. Limit protein intake, appropriate to reduce the amount of protein in the diet (0.8 / / kg · d) glomeruli can reduce stress, reduce high filtration and reduce proteinuria. In contrast to the high-protein diet will increase glomerular histological lesions. There have renal insufficiency should limit protein intake, should eat high protein containing essential amino acids.
Dialysis treatment and kidney transplantation, the event of renal failure, dialysis treatment and kidney transplantation is the only effective way. A kidney transplant is the best way to treat diabetes uremia better than dialysis. Age> 65 years of age transplantation in patients with poor results...